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The causative agent for AIDS is the retrovirus Human Immunodeficiency Virus (HIV).

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Al-Jabri, A. A. (2003). How does HIV-1 infect a susceptible human cell?: Current thinking. Journal for scientific research. Medical sciences / Sultan Qaboos University, 5(1-2), 31-44. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174721/

AIDSVu. (2020, December 2). Retrieved November 11, 2022, from https://aidsvu.org/local-data/united-states/south/texas/#hiv-mortality

Commissioner, O. of the. (2020). HIV and AIDS: Medicines to help you. U.S. Food and Drug Administration. Retrieved November 10, 2022, from https://www.fda.gov/consumers/free-publications-women/hiv-and-aids-medicines-help-you

Hughson, G. (2020, November 1). HIV lifecycle. aidsmap.com. Retrieved November 17, 2022, from https://www.aidsmap.com/about-hiv/hiv-lifecycle

khanacademymedicine. (2015, June 26). What is HIV and AIDS? | infectious diseases | nclex-RN | khan academy. YouTube. Retrieved November 10, 2022, from https://www.youtube.com/watch?v=17pfZUlAqow

PATHOLOGY OF HIV/AIDS 33rd Edition by Edward C. Klatt, MD Professor of Pathology

Department of Biomedical Sciences Mercer University School of Medicine Savannah, Georgia, USA May 24, 2022 Copyright © by Edward C. Klatt, MD All rights reserved worldwide

Strudwick, P. (2015, December 1). These posters show what AIDS meant in the 1980s. BuzzFeed News. Retrieved November 12, 2022, from https://www.buzzfeednews.com/article/patrickstrudwick/these-1980s-aids-posters-show-the-desperate-fight-to-save-li

Wilen, C. B., Tilton, J. C., & Doms, R. W. (2012). HIV: Cell Binding and Entry. Cold Spring Harbor

Perspectives in Medicine, 2(8). https://doi.org/10.1101/cshperspect.a006866

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AIDS was originally thought to be limited to gay men and was called GRID (Gay-Related Immune Deficiency). This name alone caused many men to avoid seeking treatment out of fear of being labeled gay or fear of being ostracized or fired because of the disease. But it also meant others were overlooked for years. Women were infected but undiagnosed based on their sex. Babies born with AIDS battled opportunistic infections and diseases and died before adolescence. Drug users unknowingly shared needles containing infected blood cells.

The University of Rochester’s Rare Books and Special Collections department is home to over 8,000 AIDS educational posters dating back to 1982. They illustrate the desperation felt across the world as the people, in 60 different languages, called for help diagnosing, treating, and preventing AIDS.

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Preventative measures can include using a condom, regular HIV testing, and never sharing needles or other drug paraphernalia.
There are no vaccines for HIV because it is an ever-changing virus. However, for those at high risk of exposure, PrEP (Pre-Exposure Prophylaxis) medications taken daily by mouth or every two months by injection, can provide reliable protection from HIV. PEP (Post-Exposure Prophylaxis) may be started between 1 hour and 72 hours after a known HIV exposure to prevent infection but it is a more complicated medication schedule, can cause side effects, and should only be used when necessary.

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There is no cure for HIV AIDS but, with medication, a relatively normal life can be achieved. Without medication, AIDS is likely to lead to death within 1-3 years. As the number of CD4 cells in the body decreases, the immune system struggles to fight off opportunistic infections and disease.

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There are medications called Anti-Retrovirals, that inhibit progression to Stage 3 AIDS or, once diagnosed with AIDS, suppress HIV to allow CD4 counts to increase. However, because of HIV’s ability to evolve, the likelihood of becoming medication resistant is high. To prevent this, it is highly recommended that patients use HAART, a Highly Active Antiretroviral Therapy, like Triumeq.
Triumeq includes Abacivir, a Nucleoside Reverse Transcriptase Inhibitor (NRTI), which acts as a fake nucleoside. The NRTI nucleoside does not contain the 3-hydroxyl group necessary for it to link together to create the nucleoside chain used by viral reverse transcriptase to synthesize DNA. The second medication, Dolutegravir, is an Integrase Strand Transfer Inhibitor (INSTI) that binds to the viral enzyme integrase to prevent it from splicing viral DNA into CD4 DNA. Lamivudine is the third medication, which is also an NRTI, used in Triumeq.

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HIV can be difficult to diagnose because stage 1 symptoms may present as flu-like. If indicated, an Enzyme-Linked Immunosorbent Assay (ELISA) is used to identify the presence of HIV antibodies or P24 proteins. A secondary test is used to confirm positive ELISA results. The Western Blot screens for the presence of viral envelope proteins, reverse transcriptase, and integrase.
Other testing includes Nucleic Acid Testing (NAT) to identify HIV RNA or a Rapid HIV test which uses a mouth swab or finger prick sample to screen using ELISA.

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Once HIV has infected a CD4 cell and its viral enzymes and RNA are released into the cell, it begins the process of REVERSE TRANSCRIPTION.
Reverse transcriptase uses the CD4 cell’s nucleotides, along with the HIV RNA, to synthesize a single strand of DNA. Then it synthesizes a complementary strand of DNA to make double-stranded DNA. Reverse transcription allows the viral enzyme, integrase, to splice the new DNA into the CD4 DNA.
At this point, the newly spliced DNA can be used to make envelope proteins that bud on the outside of the cell to be cleaved off as mature, infectious cells. The integration of viral DNA into the CD4 DNA also leads to apoptosis, which is one of the causes of CD4 cell death.

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HIV progresses through three stages of symptoms, depending on treatment.
+ Stage 1 may last days to weeks and include flu-like symptoms.

+ Stage 2 can last up to 10-15 years without treatment and the infected patient may be asymptomatic.

+ A patient is considered to have progressed to Stage 3, AIDS, once their CD4 (Helper T) Lymphocyte count drops below 200/microliter. When the CD4 count gets this low, patients are highly susceptible to opportunistic infections. They may experience weight loss; fever; lethargy; swollen lymph glands; sores of the mouth, anus, or genitals; skin discoloration; pneumonia; memory loss, depression, and other neurologic symptoms.

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HIV is present in most bodily fluids but only a few contain a high enough concentration of the virus to present a risk of transmission.
The most common modes of transmission are genital secretions, through genital-genital or genital-anal sex, and blood, often through shared drug paraphernalia such as needles. Breast milk also contains a high enough concentration of HIV to pose a risk of transmission.